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The present study was carried out near an industrial area with a high-density urban population and large-scale agricultural activities. These anthropogenic activities lead to groundwater pollution and depletion of the water table. This study attempted to classify pollution sources and hydrochemical facies that help to ensure the suitability of water for agriculture and drinking. Irrigation suitability indexes, water quality index (WQI), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were applied to twenty-six groundwater samples that were analysed during May 2018 for major cations and anion concentrations. The results revealed that the mechanism of groundwater chemistry has been controlled by the evaporation process with the dominance of hydrochemical facies viz., Ca-Mg-HCO3, Na-K-Cl-SO4, Ca-Mg-Cl, and Na-K-HCO3. The mean dominant concentration for cations is in the order of Ca2+ > Na+ > Mg2+ > K+ while anions are HCO3− > SO4− > Cl− > NO3− > CO32− > F−. Irrigation suitability indexes indicated that groundwater in the study area is high in saline and low to medium alkali hazards due to industrial activities. The PCA and HCA also recognized that most of the variations are elucidated by anthropogenic processes, predominantly due to excessive population, industrial emissions, and agricultural activities. Further, the WQI of the study area suggested that 15% of the samples were unsuitable, 69% poor, and the remaining 16% only suitable for drinking purposes. The present article helps to understand the suitability and hydrochemical processes of groundwater for irrigation and drinking, which will help policymakers in water supply planning and management.

Coronavirus disease-2019 (COVID-19) was declared as a pandemic by WHO in March 2020. SARS-CoV-2 causes a wide range of illness from asymptomatic to life-threatening. There is an essential need to identify biomarkers to predict disease severity and mortality during the earlier stages of the disease, aiding treatment and allocation of resources to improve survival. The aim of this study was to identify at the time of SARS-COV-2 infection patients at high risk of developing severe disease associated with low survival using blood parameters, including inflammation and coagulation mediators, vital signs, and pre-existing comorbidities. This cohort included 89 multi-ethnic COVID-19 patients recruited between July 14 th and October 20 th 2020 in Doha, Qatar. According to clinical severity, patients were grouped into severe (n=33), mild (n=33) and asymptomatic (n=23). Common routine tests such as complete blood count (CBC), glucose, electrolytes, liver and kidney function parameters and markers of inflammation, thrombosis and endothelial dysfunction including complement component split product C5a, Interleukin-6, ferritin and C-reactive protein were measured at the time COVID-19 infection was confirmed. Correlation tests suggest that C5a is a predictive marker of disease severity and mortality, in addition to 40 biological and physiological parameters that were found statistically significant between survivors and non-survivors. Survival analysis showed that high C5a levels, hypoalbuminemia, lymphopenia, elevated procalcitonin, neutrophilic leukocytosis, acute anemia along with increased acute kidney and hepatocellular injury markers were associated with a higher risk of death in COVID-19 patients. Altogether, we created a prognostic classification model, the CAL model (C5a, Albumin, and Lymphocyte count) to predict severity with significant accuracy. Stratification of patients using the CAL model could help in the identification of patients likely to develop severe symptoms in advance so that treatments can be targeted accordingly.

There is a lack of predictive markers for early and rapid identification of disease progression in COVID-19 patients. Our study aims at identifying microRNAs (miRNAs)/small nucleolar RNAs (snoRNAs) as potential biomarkers of COVID-19 severity. Using differential expression analysis of microarray data (n = 29), we identified hsa-miR-1246, ACA40, hsa-miR-4532, hsa-miR-145-5p, and ACA18 as the top five differentially expressed transcripts in severe versus asymptomatic, and ACA40, hsa-miR-3609, ENSG00000212378 (SNORD78), hsa-miR-1231, hsa-miR-885-3p as the most significant five in severe versus mild cases. Moreover, we found that white blood cell (WBC) count, absolute neutrophil count (ANC), neutrophil (%), lymphocyte (%), red blood cell (RBC) count, hemoglobin, hematocrit, D-Dimer, and albumin are significantly correlated with the identified differentially expressed miRNAs and snoRNAs. We report a unique miRNA and snoRNA profile that is associated with a higher risk of severity in a cohort of SARS-CoV-2 infected patients. Altogether, we present a differential expression analysis of COVID-19-associated microRNA (miRNA)/small nucleolar RNA (snoRNA) signature, highlighting their importance in SARS-CoV-2 infection.

Hydrochemistry and bed sediment geochemistry are two key components for understanding the dynamics of earth’s processes. The present study examines the impact of land use/land cover and morphometric characteristics of the watersheds on streams water hydrochemistry and geochemistry of fine fraction of bed sediment. To achieve our objectives, we collected and analyzed 21 stream water and bed sediment samples. We found that the geochemistry of the fine fraction and stream hydrochemistry did not exhibit a strong relationship, likely because of non-equilibrium with fast-moving stream water. Glacier cover in watersheds influences the total dissolved solids (TDS), chloride, and nitrate in stream water. Dark minerals in bed sediment influence K + and Mg +2 ions and the bed sediment characteristics exert control over the K + concentration in streams water. The concentration of dissolved silica in stream water exhibits a high dependency on elevation, gradient, circulatory ratio, and form factor. The geochemistry of bed sediments reveals that fine sediments have undergone little or no chemical weathering and, hence, have a low Chemical Index of Alteration (CIA). The lack of a relationship between the geochemistry of fine sediments and bed sediment mineralogy highlights the complex origin of fine sediments other than bed sediment weathering. The morphometric parameters of the watersheds reasonably control the Na 2 O, K 2 O, and Al 2 O 3 concentrations in the fine fraction of bed sediments. Agricultural activity influences the Fe 2 O 3 and P 2 O 5 concentrations in fine sediments. Barren land and forest exhibited positive and negative relationships, respectively, with mobile oxides in the fine sediment.

Objective This study aimed to assess the knowledge and attitudes of pregnant females in Al-Ahsa city, Kingdom of Saudi Arabia (KSA) toward hepatitis B virus infection. Methods A cross-sectional study was done at the Maternity and Children's Hospital, Al-Ahsa. A total of 422 of every third pregnant women were recruited from 6/12/2019 to 20/12/2019. Self-administered questionnaire was provided that contained three aspects: sociodemographic, perception and source of information about hepatitis B, and attitude toward hepatitis B infection. Analysis was performed using SPSS version 21 (IBM Corp., Armonk, NY). Results A total of 422 pregnant women participated in this study with a response rate of 93.7%. Among them, 44.79% had a university degree or higher education level, about 82% had information about hepatitis B virus (HBV) during their pregnancy, 0.9% knew a person with HBV, 48.1% knew that hepatitis B is caused by virus, 72% knew that hepatitis B has vaccine, 41.9% knew that hepatitis B spreads via mother, 79.6% were willing to do hepatitis B test during pregnancy, 80.1% were willing to allow for kids' vaccination against HBV, and 83.4% were willing to allow their kids for hepatitis B testing. There was a significant relationship between the level of education and the knowledge score. And there was a significant relationship between the level of education and attitudes score. Conclusion There is insufficient knowledge among pregnant women regarding hepatitis B infection, while pregnant women showed remarkably positive attitudes regarding therapy and immunization. So, we highly recommend for awareness campaigns about viral hepatitis regarding means of transmission, and possible treatment options.

In Saudi Arabia, carbon footprint and energy use related to building materials, notably concrete in construction, have a significantly negative effect on the environment. Likewise, the impact of annual cooling and heating energy demands has an equally prominent role to play. These must all be assessed and benchmarked in order that reduction targets can be set. Saudi Arabia presents its own unique context and local conditions that create a challenge when utilising generic frameworks for assessing the environmental impact of domestic buildings. In meeting this aim, this PhD research presents a resilience and environmental sustainability assessment framework (RESAF) developed specifically for domestic buildings in Saudi Arabia. The RESAF helps designers/builders to minimise the carbon footprints of building fabric and reduce the in-use energy demands of domestic buildings in Saudi Arabia. This study shows how this framework can be used to reduce the carbon impact of construction materials by approximately 23%, primarily by substituting a portion of cement for pulverised fly ash (PFA) or ground granulated blast furnace slag (GGBS). A reduction of 32% in the annual cooling and heating energy demand could also be achieved throughout a building's life simply by changing insulation type and thickness, and using triple-glazed windows. The importance of passing these alternative solutions through the resilience filter - to pressure test them in 3 archetypal futures (i.e. those related to Policy, Sustainability and Market Forces) - is highlighted, and helps ask questions about whether they are really fit-for-purpose whatever the future might hold. A user manual has been drawn for ease of RESAF utilisation, and a case study example is used to illustrate the framework and the potential carbon / energy savings that can be made through material choice(s) and long term use of the building. Application in a range of cities in Saudi Arabia has been considered in order to illustrate the influence of local context and conditions even with one country, particularly in terms of the cooling and heating energy performance. The RESAF was validated by consulting experts in Saudi Arabia via interviews and compared with past studies, all of which showed that it conformed to potential RESAF users' expectations.

Historicising social housing delivery approach is extensively carried out for Western countries, but studies of social housing policy journey are less focused on developing nations and examining the policy development within resource-abundant Middle Eastern countries is even rarer. Applying a critical juncture approach through the historical institutionalism lens, this paper seeks to understand the evolution of social housing policies within the Saudi Arabian context. An in-depth policy review suggests that the institutional response in this sector has transitioned from a public-welfare perspective to a more neoliberal vision in recent times. The study also indicates a time-lag in policy development regarding social housing within the urban development process in Saudi Arabia compared to global movement. During the past few years, the government has begun to focus on social housing under the developmental housing program with a commitment to link these strategies to the Saudi Vision 2030. While this is a significant policy-shift in the service delivery approach, such vision could be workable as long as sufficient room is built in for other non-government actors to work within their specific protocols and frameworks as they collaborate to provide affordable and appropriate housing for the neediest groups of the society.

Introduction: The emergence of the coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the globe. Understanding the association between the population's demographical, clinical risk factors, and outcome of COVID-19 is essential for healthcare providers to develop guidelines and future care plans. This study reports all diagnosed COVID-19 and admitted to Johns Hopkins Aramco Healthcare (JHAH) for hospitalization from March to July 2020. Methods: This is a retrospective study that presents the demographic, epidemiological, clinical, laboratory, and imaging characteristics of our patients and determines risk factors contributing to their COVID-19 outcome. Results: The study included 656 patients (53% were male, 60% were older than 50 years of age, 87% were Saudi nationals, 5% pregnant, and 92% non-smokers patients). The source of infection was mostly unknown to the patient or healthcare provider (58%), followed by contact transmission (36%) and travel (5%). In addition, we found that the vast majority of hospitalized patients presented with symptoms (76%) with (90.4%) mild to moderate symptoms and have had stable hospital course during their hospitalization (82.1%). Over fifty percent of the patients had abnormal x-ray upon admission, (4.7%) were intubated, (20.3%) were admitted to an intensive care unit (ICU) or a step-down unit (SDU), and finally (5.3%) were deceased. Conclusion: The majority of the patients in this study had mild disease, and their outcome was associated with some chronic diseases, most significantly hypertension. However, the study did not demonstrate a statistically significant association between smoking and obesity and COVID-19 outcomes. Keywords: COVID-19, chronic illness, outcome, epidemiology

 Orthopedic surgery is a tiring specialty both physically and mentally. Surgeons tend to hold strenuous postures for long periods of time. Orthopedic surgery residents are affected just as much as their seniors by the difficult ergonomics. More care should be aimed toward healthcare professionals to improve patient outcomes and decrease the burden on our surgeons. The goal of this study is to pinpoint the areas of musculoskeletal pain among orthopedic surgery physicians and residents and its prevalence in the eastern province of Saudi Arabia.  A cross-sectional study was conducted in the Eastern region of Saudi Arabia. A simple random selection of 103 male and female orthopedic surgery residents from Saudi Commission for Health Specialties accredited hospitals was enrolled in the study. Residents enrolled from the first to fifth year. Data were collected using a self-administered online questionnaire based on the musculoskeletal Nordic questionnaire activated in 2022-2023.  Out of 103, a total of 83 completed the survey. The majority (49.9%) were junior residents from residency year (R) 1-R3 and exactly 52 (62.7%) residents were males. The majority of the participants, which were 35 physicians (55.6%), perfume less than six operations as average operations per week, and duration stay in the operating room (OR) per operation there were 29 physicians (46%) stay in the OR for 3-6 h. The most reported sites of pain included lower back pain (46%), followed by neck pain (39.7%) and then upper back pain (30.2%). About 27% of the participants had the pain for more than 6 months, however, only 7 (11.1%) residents seek for medical help. Considering the associated factors with MSP, smoking, and residency year were significantly associated with having musculoskeletal pain (MSP). The presence of MSK pain among R1 residents represents 89.5%, in comparison with R2 residents Who reported 63.6% and 66.7% among R5 residents. This finding indicates a decrease in MSP among residents over the 5 years of residency programs. Additionally, the majority of the participants with MSP reported being smokers 24 (88.9%), controversy, only three of the participants represent (11.1%) without MSP and smokers.  Musculoskeletal pain is a serious issue that needs to be addressed. The results indicate that the most reported areas of MSP were the low back, neck, and upper back. Only a minority of the participants went to seek medical help. Residents from R1 experienced more MSP than their seniors and this could indicate an adaptive behavior from senior staff. More research should be done on the topic of MSP in order to promote health among caregivers across the kingdom.

Introduction Despite the overwhelming amount of evidence against the use of aspirin for primary prophylaxis of cardiovascular disease (CVD), the arguably unwarranted use of aspirin has increased over the years, which may or may not be based on any specific medical advice, and merely self-prescribed. Aim This study aimed to determine the prevalence of unwarranted aspirin use among moderate-risk individuals for the primary prevention of adverse vascular events in Saudi Arabia. Patient and method A cross-sectional study was conducted among 100 patients who presented to the emergency room (ER) due to suspected cardiac diseases. The data were collected from the patients who visited ER in King Fahad Hospital, Al-Hofuf, Saudi Arabia. Participants were asked about their socio-demographic characteristics, aspirin use habits, and their comorbidities. Results Of the 100 patients, 35% were aged more than 60 years old. The overall use of aspirin was 78%. The prevalence of aspirin use was significantly more common among the older age group (53.8%), those with associated chronic diseases, such as diabetes (59%) and hypertension (75.6%) and those with a previous history of hospitalization due to stroke or a cardiac event (66.7%). Conclusion The use of aspirin among patients who are at moderate risk of cardiovascular events was widely prevalent, but their unwarranted use was low. Older patients with chronic diseases who believed in its great benefit and tended to ignore its complications are the most common users of aspirin. More research is recommended to determine the prevalence and the factors associated with unwarranted use of aspirin in patients with CVD in our region.